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Homophobia in the Age of AIDS

By Dr. George, Ayala Executive Officer

May 17, 2010

Dr. George Ayala, Congressmember Barbara Lee, and Othman Mellouk, MSMGF Co-Chair and President of Morocco’s Association de Lutte Contre le Sida Maroc at a March 1 open house announcing MSMGF’s new headquarters in downtown Oakland

Angelinos know George Ayala, PsyD, from his terrific work as a social scientist and as the former Director of Education at AIDS Project Los Angeles for many years. He was always the man to call for a reliable explanation of research on demographics and prevention issues such as stigma. As we consider the International Day Against Homophobia, I urge you to read this article and consider the link to HIV/AIDS. - Karen Ocamb

Though the International Day Against Homophobia (IDAHO) has a relatively short history, each passing year makes a stronger case for its existence. In the twelve months since the last IDAHO took place, same-gender loving men and women in Uganda faced the prospect of execution, visitors to a gay health clinic in Kenya were doused in gasoline, and roving death squads tortured, murdered and dismembered effeminate men in Iraq.

It takes no stretch of imagination to understand that atrocities like these are the product of homophobia. They are vile and horrifying and we should do everything in our power to stop them. To understand the full effect of homophobia, however, one must look past the most obvious examples. As the body of literature on homophobia grows, it has become clear that it plays a driving role in another human rights crisis—the AIDS crisis.

Gay men and other men who have sex with men (MSM) are at higher risk of contracting HIV, regardless of what region of the world they live in. MSM in low- and middle-income countries are, on average, 19 times more likely to be infected with HIV than the general population. Wealthy countries are no exception, with MSM in the United States, United Kingdom, and Australia experiencing infection rates up to 44 times higher than those of their heterosexual counterparts.

The history of AIDS in the United States is littered with examples of homophobia’s role in the spread of HIV. We watched President Reagan drag his feet in the earliest days of the epidemic, refusing to acknowledge a growing public health emergency, while what was then known as Gay Related Immune Deficiency killed thousands of gay men from New York to San Francisco. Denial continues to drive our epidemic today, reflected in HIV prevalence rates among Black MSM and other MSM of color as high as those in the hardest hit nations in Sub-Sahara Africa.

While we are still struggling to reverse these trends in the United States, this same brand of denial remains alive and well around the world. Despite soaring prevalence rates recorded among MSM in a wide variety of country contexts—Colombia, 19.4%; Senegal, 21.5%; Thailand, 24.6%—silence and inaction plague the global response, with more than 90 countries failing to report any data on the number of MSM reached by prevention efforts in their 2008 evaluations to the United Nations.

Refusal to acknowledge a flaring epidemic can be compounded by discriminatory laws that make outreach work nearly impossible. Homosexuality is against the law in nearly 80 countries around the world. If MSM in these countries wish to discuss their sexual risk factors with an HIV service provider, they must risk criminal sanctions to do so. Organizations that attempt to provide MSM-specific services in these settings face similar risks and are often accused of “promoting homosexuality.”

Even in countries where homosexuality is not specifically criminalized, experiences of homophobia can drive MSM underground, making them hard to reach with salient prevention programs and information. Homophobic comments by healthcare providers are common and particularly harmful, pushing MSM away from clinics that are often the only source of HIV prevention, testing, and treatment. These factors combined work to disconnect and disenfranchise MSM from the information, services, and support they need to protect themselves from HIV. Tragically, these same homophobic actions that hinder health-seeking behavior also exacerbate risk of HIV transmission – more and more studies indicate that MSM who experience higher levels of social discrimination are more likely to engage in risky sexual behavior.

Today, on IDAHO 2010, hundreds of organizations around the world are engaging in campaigns for the legal protection, social acceptance, and basic human rights denied to millions of men and women because of their sexual orientation. As we struggle to overcome the root causes and effects of homophobia, we must consider its full effect on the lives of same-gender loving men and women – including its impact on health and HIV. Without ending homophobia, we have no hope of ending AIDS.

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URL to article: http://www.lgbtpov.com/2010/05/homophobia-in-the-age-of-aids/